Acute Generalized Exanthematous Pustulosis Induced by Olanzapine

The case of a 56 years old man is presented, who developed acute generalized exanthematous pustulosis 5 days after the introduction of olanzapine 10 mg. Multiple 1-mm pustules appeared on the whole body, concentrated especially on her neck and face. Within 2 days, the eruption was increasingly accompanied by erythema and pruritus. No fever, chills, nausea, vomiting, arthralgias or myalgias were recorded. The diagnosis was corroborated by hystopathology. After 7 days of treatment, olanzapine and valproate were stopped. Concomitantly, cetirizine 20mg p.o. and methylprednisolone 500 mg i.v. were given once. During the following week betamethasone cream was applied, and the pustular eruption resolved completely.

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A Case of Ceftriaxone-Induced Acute Generalized Exanthematous Pustulosis/Generalized Pustular Psoriasis Overlap

Case Reports in Dermatology ◽

10.1159/000488076 ◽

2018 ◽

Vol 10 (1) ◽

pp. 69-75 ◽

Cited By ~ 2

Author(s):

Jianfeng Zheng ◽

Yunlu Gao ◽

Xuemei Yi ◽

Yangfeng Ding

Keyword(s):

Pustular Psoriasis ◽

Whole Body ◽

Complete Regression ◽

Clinical Form ◽

Acute Generalized Exanthematous Pustulosis ◽

Plaque Type ◽

Generalized Pustular Psoriasis ◽

History Of ◽

Exanthematous Pustulosis ◽

Missense Substitution

Acute generalized exanthematous pustulosis, characterized by subcorneal or superficial intraepidermal pustules, is induced by drugs in more than 90% of cases. Psoriasis is an autoimmune disease triggered by different conditions in genetically susceptible people. Generalized pustular psoriasis is an acute and severe clinical form of psoriasis, which usually occurs in patients with psoriasis undergoing aggravating factors. In this report the authors have reported a 40-year-old male patient with primary syphilis who developed generalized pustular dermatosis after the use of ceftriaxone. On the third day after ceftriaxone treatment, complete regression of the syphilis lesions was reached. While on the sixth day, erythematous pustular lesions accompanied with fever were observed on the whole body. A personal history of psoriasis and histopathological findings with psoriasiform changes and subcorneal pustule favored the diagnosis. After discontinuation of ceftriaxone, the patient’s condition slowly improved until he had plaque-type psoriasis 3 weeks later. A heterozygous c.115 + 6T>C missense substitution of IL36RN related to the pathogenesis of acute generalized exanthematous pustulosis/generalized pustular psoriasis was identified.

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Acute Generalized Exanthematous Pustulosis in a Patient after Stem Cell Transplantation

Journal of Cutaneous Medicine and Surgery ◽

10.2310/7750.2010.09045 ◽

2010 ◽

Vol 14 (4) ◽

pp. 181-184

Author(s):

Petra Cetkovská ◽

Nina Benáková

Keyword(s):

Stem Cell ◽

Stem Cell Transplantation ◽

Cell Transplantation ◽

Hematopoietic Stem ◽

Pustular Eruption ◽

Immune Alteration ◽

Acute Generalized Exanthematous Pustulosis ◽

Cutaneous Adverse Reaction ◽

History Of ◽

Exanthematous Pustulosis

Background: A severe generalized pustular eruption occurred several months after allogeneic hematopoietic stem cell transplantation for multiple myeloma in a patient being treated with antibiotics for respiratory infection. Neither he nor his donor had a history of psoriasis. Methods: The patient was treated with drug withdrawal and administration of cyclosporine and methylprednisolone without improvement; later, acitretin and methylprednisolone were used successfully. The eruption slowly subsided, and therapy was discontinued. Four months later, the patient experienced a recurrent severe pustular eruption associated with fever and leukocytosis, and the same treatment was used successfully again. Results and Conclusion: The patient has not experienced relapses in the ensuing 3 years. Acute generalized exanthematous pustulosis is a rare cutaneous adverse reaction triggered most commonly by drugs with a tendency to resolve spontaneously. The surprisingly prolonged, refractory, and relapsing course of the eruption in our patient might be due to the immune alteration and the polypharmacologic therapy after stem cell transplantation. Antécédents: Une éruption pustulaire généralisée aiguë s'est produite chez un patient traité aux antibiotiques contre une infection respiratoire, plusieurs mois après une allogreffe de cellules souches hématopoïétiques pour myélome multiple. Ni le patient ni le donneur n'ont des antécédents de psoriasis.

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Pustular eruption after biosimilar rituximab infusion: report of acute generalized exanthematous pustulosis in two patients with pemphigus

International Journal of Dermatology ◽

10.1111/ijd.15706 ◽

2021 ◽

Author(s):

Maryam Daneshpazhooh ◽

Soheil Tavakolpour ◽

Ali Salehi Farid ◽

Mehrnoosh Ebadi ◽

Ali Nili ◽

...

Keyword(s):

Pustular Eruption ◽

Acute Generalized Exanthematous Pustulosis ◽

Exanthematous Pustulosis

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Steroid-resistant Acute Generalized Exanthematous Pustulosis Mimicking Generalized Pustular Psoriasis Successfully Treated by Methotrexate

Revista da Sociedade Portuguesa de Dermatologia e Venereologia ◽

10.29021/spdv.79.3.1327 ◽

2021 ◽

Vol 79 (3) ◽

pp. 257-260

Author(s):

Khairuddin Djawad

Keyword(s):

Inflammatory Cell ◽

Pustular Psoriasis ◽

Clinical Form ◽

Drug Induced ◽

Laboratory Findings ◽

Steroid Resistant ◽

Pustular Eruption ◽

Acute Generalized Exanthematous Pustulosis ◽

Generalized Pustular Psoriasis ◽

Exanthematous Pustulosis

Acute generalized exanthematous pustulosis is a rare drug-induced eruption that is characterized by sterile non-follicular pustules arising on an often edematous diffuse erythematous background. Generalized pustular psoriasis is an acute and severe clinical form of psoriasis presenting as pustular eruption with erythematous base. Differentiating both diseases is often challenging because of their clinical and histopathological similarities. A 62-year-old woman presented with pustular eruption and fever three days after taking propyphenazone. Laboratory findings revealed leukocytosis and neutrophilia. Histopathological findings revealed a subcorneal spongiform pustule filled with neutrophils and perivascular inflammatory cell infiltration with neutrophils in the dermis. She was initially treated with systemic steroids, however, the lesions showed insignificant improvement. Treatment was then shifted to methotrexate which resulted in a dramatic clinical improvement.

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